Tennessee Physicians: Maintenance of Certification A Costly Burden
Survey Reveals Doctors’ Frustrations with Medical Specialty Board Processes
July 28, 2015
NASHVILLE – The Tennessee Medical Association has released findings of a statewide survey regarding physicians’ required maintenance of certification (MOC) by various medical specialty boards. According to the data, most Tennessee physicians feel the cost and effort associated with certification and/or recertification of a medical specialty is unreasonable and does not produce a measurable return on investment in terms of patient care.
The MOC process has for years stirred controversy in the medical community from some physicians who have grown weary of what they consider to be excessive fees and overly frequent testing requirements. The TMA House of Delegates passed a resolution during the Association’s annual convention in April 2015 calling for the Board of Trustees to report the findings of the survey, which was conducted in 2014, and study the results to determine what, if any, national advocacy efforts it can support to improve the MOC process. MOC is not a state-level issue.
Key findings of the survey:
Approximately 64% of respondents have had multiple recertifications after their residency or fellowship, and more than half of those have undergone recertification two or more times.
Besides a written test, 88% of respondents said their board has additional requirements to satisfy a specialty certification.
The average cost among respondents to become certified by their specialty boards is approximately $2,250, and sometimes thousands of dollars more to be recertified. More than 80% felt these costs are unreasonable, especially when adding indirect costs such as travel, time away from the office and lost productivity.
A majority of respondents invested significant amounts of time and money in review courses to prepare for recertification. More than one in three physicians begin preparing at least one year in advance.
One in four physicians said they intend to relinquish their board specialty certifications before retiring from medicine, while 74% plan to let it lapse after they retire. Only 20% of respondents plan to retire within the next five years.
“Our survey validates what so many of us have experienced for our entire careers. MOC programs are expensive, laborious exercises that we incur not because we feel like it makes us better doctors, but because in many ways it has become a requisite to practice medicine and continue serving our patients,” said Dr. John W. Hale, Jr., a family physician in Union City, Tenn. and President of the TMA.
The TMA would like to see more reasonable use of testing, certification and recertification focused on keeping doctors current with clinical best practices that produce efficient, quality care, said Dr. Hale.
“Doctors do not shy away from continuing education and professional development. We meet many of those requirements through the state licensure boards. But the MOC process has caused more and more physicians to question the costs and whether it truly enhances physicians’ clinical knowledge and skill set. There is a clear feeling in the medical field that MOC is a revenue center on which the medical specialty boards continue to capitalize.”
According to the American Board of Medical Specialties, programs for board certification and MOC provide a trusted credential and uphold the integrity of medical specialty care. Certification is a voluntary process designed to demonstrate a physician’s expertise in a particular medical specialty and/or subspecialty. MOC is a system for ongoing professional development.
The ABMS and its 24 member boards develop and administer testing processes, including how often physicians are required to renew their certifications, and at what cost.
While programs are voluntary through ABMS and its member boards, certification is often required for hospital employment, hospital affiliations and even agreements with insurance companies.
“We are starting to see unintended consequences of these programs from doctors who are exhausted by the costs and requirements. If doctors choose not to get recertified, it jeopardizes their patients’ access to care and/or patients have to pay higher out of network costs to continue seeing their doctor.”
More than 300 physicians responded to the TMA survey, with 96% of respondents indicating they currently hold certification from a specialty board. TMA serves more than 8,000 members statewide.
For more information, visit tnmed.org/MOCsurvey.